Therapy / Intervention

Therapy / Intervention

Focus On Ways to Relax and Regulate Body

  • Find ways to help the youth relax and regulate their body. These interventions can include art, drama, sports, martial arts, music therapy, equine therapy, occupational therapy etc.

  • Consider creating a calming toolkit that includes simple self-regulation options. This would be a personalized self-care or resiliency toolkit/checklist that the youth carries with them or post the checklist somewhere prominent (bathroom mirror). It could include words or pictures of the calming things that they prefer. For example:

    • Words like “I am here. I am safe. I am okay right now.”
    • A simple breath awareness technique like exhaling through pursed lips.
    • Physical activity and exercise.

    This would be something to practice with frequency. Repetition is key, so that these techniques are available in the “hot moment.”

  • If the youth needs sensory regulation, consider prioritizing physical activity and exercise be a part of the daily routine. Include activities that provide proprioceptive input that can be calming and organizing to the sensory system. This includes running, jumping, pushing , pulling, yoga, or other types of ‘heavy work’. Swinging, spinning or other vestibular input should only be directed by the youth and never imposed by others as it can overwhelm the sensory system.

 

Support for Sensory Needs & Regulation

  • Teach self-regulation and/or co-regulation, along with coping strategies.
  • Encourage the identification and expression of feelings by applying social and emotional learning (SEL) strategies.
  • Use portions of Zones of Regulation Curriculum to teach simple self-regulation skills (sensory based strategies or “sensory tools” and cognitive based strategies or “thinking tools”).
    • A caution – Functioning Interoceptive Awareness (recognizing body signals and then giving them meaning) is needed for a child to develop self-regulation skills.
  • Build Interoceptive Awareness and Mindfulness to support youth.
  • Address any Interoception needs to support the transition from co-regulation to self-regulation.
  • Promote Feelings of Safety – Create a ‘Feel Good Menu’ (read more about this in the link provided) or a specific Sensory Diet based on youth’s needs and use it across environments. These activities are done proactively and routinely during the day in order to increase feelings of felt safety.

Accessibility Updates in Progress Notice

We are currently working to update content in this toolkit for accessibility. If you have difficulty accessing any of the content while we are making updates, please contact GRCAccess@osumc.edu

Regulation Tools and Other Resources

Leverage Strengths and Interests

  • Identify the youth’s strengths and use those strengths as ways to increase skills. Use a strength-based approach when prioritizing goals for treatment plans. Individualized Behavior Support Plans should build on the youth’s strengths and interests while remaining consistent with established goals.
  • Focus interventions on interests and preferences. Include opportunities to learn using examples and activities related to interests to break up the day or provide space to regulate.
  • Figure out the function of interests. If youth likes mowing (i.e., humming tunes out noise, likes to create patterns) or doing laundry (i.e., smells, noises, feeling like they are helping) then build on those in other areas.
  • Identify any leadership skills that can be utilized to help give youth a sense of purpose. Help youth to understand their value and worth through exploring and expanding these strengths.
     

Trauma-Informed Strength-Based Approach in Therapy

Consider a trauma-informed strength-based approach in therapy to increase the youth’s social, problem solving, and regulation skills.

Using a trauma-informed approach is important for youth who have past traumas and have significant difficulty with mood and behavioral regulation.

Trauma-informed Experiential Play Therapy

  • Consider trauma-informed experiential play therapy to increase social, problem solving, and regulation skills.

  • It may also be helpful to use trauma-informed experiential family therapy to increase engagement and work on problem solving, coping, and social skills in the home.

Trauma-informed Family Therapy

  • If traumatic events have occurred with the youth in the home, consider trauma-informed family therapy as part of the youth’s treatment plan.

 

Family Resources

Group Therapy for Youth

  • If the youth has a history of problems with peers, consider having youth participate in group therapy to increase problem solving, social, and mood management skills.

 

Mental Health Resources

Service and Care Coordination Resources

  • Intensive Home based Treatment (Ohio Department of Behavioral Health)

    Intensive Home-based Treatment (IHBT) is a mental health service designed to meet the needs of youth with serious emotional disturbances who are at risk of out-of-home placement or who are returning home from placement.

  • Wraparound Ohio Resources

    The Wraparound process is a way to improve the lives of children with complex needs and their families. It is not a program or a type of service, but a team based planning process used to develop plans of care that are individualized based on the strengths and culture of the children and their family. The plan is needs-driven rather than service-driven, although a plan may incorporate existing categorical services, if appropriate to meet the needs of the consumer.

  • Ohio Family and Children First

    Ohio Family and Children First (OFCF) is a partnership of state and local government, communities and families that enhances the well-being of Ohio’s children and families by building community capacity, coordinating systems and services, and engaging families. OFCF's vision is for every child and family to thrive and succeed within healthy communities.

  • Patient-Centered Medical Homes (Ohio Department of Health)

    The Patient-Centered Medical Home model of care is one that facilitates partnerships between individual patients and their personal healthcare providers and, when appropriate, the patient’s family.

  • FIRST Coordinated Specialty Care for First Episode Psychosis

    FIRST Coordinated Specialty Care for First Episode Psychosis programs are available throughout Ohio and are committed providing to the best treatment services for individuals experiencing an initial episode of psychotic illness and their families as early in the course of the illness as possible.

  • Mobile Response and Stabilization Services (MRSS)

    MRSS is a community-based intervention that provides immediate support to young people, aged 20 and under, who are experiencing mental, emotional or behavioral distress or any other traumatic circumstances that has impacted their ability to function within their family, school, or community.

Use of Visual Supports, Role Playing, or Modeling

  • Completing activities in more than one modality (e.g. talk about the problem, complete a role play about the problem, draw a picture about the problem) can help increase the level of learning.
  • Utilize pictures and visuals as part of a plan to decrease use of language when youth is dysregulated or stressed. A visual support can be used (with a simple pointing gesture) to let others know how they are feeling or when they are in a state where they can’t follow verbal cues or directions.
  • Using visual supports rather than written instructions for detailing the day’s schedule or breaking down daily responsibilities can decrease stress/anxiety for a youth who may be struggling with decoding the written word.
  • Visual aids can provide cues to remind the youth of healthy coping techniques, what they can expect for upcoming transitions, or ways to express themselves. They may enjoy the process of helping to create these resources with a provider or family member.
  • Role playing situations that led to past activations may help identify triggers to dysregulating behaviors and inform interventions. Resources such as social stories, games, art, dolls, etc. are interactive ways to help the youth practice playing and explore feelings, thoughts, and behaviors.
  • Using Social Narratives (Social Stories) for any activity which tends to produce anxiety can assist communication. Social stories and pictures can help guide discussions about triggers for certain behaviors and teach the youth how to understand their body’s cues (upset stomach, tension in shoulders or jaw) as part of his understanding of when and how things escalate. Youth may enjoy including characters they enjoy or can relate to in stories.
     

Social Narratives Resources

A variety of visual supports can be used to prepare or prime an individual for any situations they have encountered or will encounter. Social narratives are simple stories that visually represent social situations and appropriate social behaviors.

  • OCALI Grab and Go Resource Templates

    The OCALI Autism Center Grab and Go Resource Gallery of Interventions has visual supports that can be used to decrease use of language when youth is dysregulated. Completed and blank templates are free and available to download.

Other Therapy Resources

Motivational Interviewing Resources

Equine Therapy Resources

Reading Recommendations

Toolkit Topics

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